Relationship between voice and speech perception in children with cochlear implant

TEMA: o uso do implante coclear resulta na otimização da percepção de fala, e conseqüentemente no desenvolvimento da linguagem, fala e voz de seus usuários, sendo que tem se mostrado uma das tecnologias mais efetivas e promissoras para remediar a perda auditiva. Entretanto, pouco tem sido estudado sobre a relação das habilidades auditivas com a voz de crianças implantadas. OBJETIVO: relacionar as habilidades de percepção de fala com características vocais de crianças usuárias de implante coclear. MÉTODO: foram realizadas análises perceptivo-auditiva e acústica da vogal sustentada /a/ e da contagem de números. Essa análise foi comparada a um teste de percepção de fala padronizado que avalia o reconhecimento de palavras, seus fonemas e consoantes. RESULTADOS: observou-se que quanto maior o reconhecimento de consoantes, maior a freqüência máxima, desvio padrão da freqüência fundamental e média de intensidade durante a fala encadeada, assim como a média da freqüência fundamental na análise da emissão da vogal /a/. Além disso, quanto maior o reconhecimento de consoantes menor o desvio geral da qualidade vocal e da ressonância. CONCLUSÃO: dentre as crianças com implante coclear, as que possuem melhor habilidade de percepção de sons da fala apresentam menores desvios perceptivo-auditivos na qualidade vocal.BACKGROUND: the use of cochlear implant results in the optimization of speech perception, and, as a consequence in the development of oral language, speech and voice of its users, demonstrating to be one of the most effective and promissing technologies to remediate hearing loss . However, little has been studied about the relationship between auditory skills and the voice of children using cochlear implants. AIM: to relate the speech perception abilities to the vocal characteristics of cochlear implant users. METHOD: perceptive and acoustic analysis of the long vowel /a/ and counting of numbers were carried out. This analysis was compared to a standardized speech perception protocol, that evaluates the recognition of words, its phonemes and consonants. RESULTS: it was observed that the higher the recognition of consonants, the higher the maximum frequency, standard deviation of the fundamental frequency and average of intensity during the sequential speech, as well as fundamental frequency average during the emission of the vowel /a/. Also, the higher the recognition of consonants, the lower the standard deviation of the quality of voice and resonance in the perceptive-auditory analysis. CONCLUSION: among the children with cochlear implants, the ones with better speech perception abilities present lower perceptive-auditory deviations of the quality of voice

The use of different stingless bee species to pollinate cherry tomatoes under protected cultivation

Under standard greenhouse conditions, the tomato fruits of spontaneous self-pollination are expected to be of lower quality than those of bee pollination, as well as that simultaneously use different bee species which can complement pollination services. To test these hypotheses, we evaluated the complementarity of pollination services from the use of three native stingless bee species that have distinct foraging behaviors, Melipona bicolor Lepeletier 1836, Nannotrigona testaceicornis (Lepeletier 1836) and Partamona helleri (Friese 1900) during flowering of cherry tomatoes in greenhouses. Fruit quality parameters resulted from pollination experiments were measured and the acclimatization of the analyzed bee species was evaluated. Visits of M. bicolor and N. testaceicornis to the tomato flowers contributed significantly to the increase in the average weight, seed number, and thickness of the pericarp (only for N. testaceicornis) of the fruits, compared to the spontaneous self-pollination treatment. Partamona helleri, however, did not show any pollen collection behavior in the experimental conditions. Although N. testaceicornis do not perform the buzzing behavior, fruits from its pollination were equivalent to those fruits from pollination by M. bicolor. The simultaneous use of bee species with different flower-visiting behaviors can optimize tomato pollination in greenhouses, contributing significantly to the quality of the fruits and the increase of productivity and consequently the commercial value

INTERFACE: AS DANÇAS DE ANA EM LAVOURA ARCAICA

The aim of the present study was to analyse and reflect on the representations of Ana’s dances in Lavoura arcaica, literary and filmic works of Raduan Nassar e Luiz Fernando de Carvalho, respectively, using as the main theoretical reference Rudolf Von Laban. It was possible to conclude that, in the absense of verbal expression, Ana channels her desire of communication into her dances. In her first dancing manifestation, she shows marks of tradition, and in her second and last dance, the signs of rupture.Este estudio tiene como objetivo reflexionar y analizar la representación de danzas de Ana en Lavoura Arcaica, obra literarias de Raduan Nassar, y cinematográfica de Luiz Fernando Carvalho, teniendo como uno de los principales teóricos Rudolf Von Laban. Se concluyó que, en ausencia de la expresión verbal, Ana canaliza su deseo de comunicarse a través de la danza. En su primera manifestación de baile enseña rasgos de la tradición, ya en la segunda y última danza, presenta los signos de ruptura.Este estudo propõe refletir e analisar a representação das danças de Ana em Lavoura arcaica, obra literária de Raduan Nassar e fílmica de Luiz Fernando Carvalho, tendo como um dos principais referenciais teóricos Rudolf Von Laban. Foi possível concluir que na ausência de expressão verbal, Ana canaliza o seu desejo de comunicação em suas danças. Em sua primeira manifestação dançante exibe marcas da tradição e em sua segunda e última dança, os sinais da ruptur

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses

Fortalecendo o protagonismo da Comissão de Integração Ensino-Serviço para a educação permanente em saúde

Objetivo: Conhecer a atuação de universidades junto à Comissão Permanente de Integração Ensino-Serviço da Região Oeste de Santa Catarina, com vistas a fortalecer seu protagonismo no desenvolvimento de iniciativas de educação permanente em saúde.Metodologia: Pesquisa Convergente Assistencial desenvolvida no primeiro semestre de 2014, envolvendo entrevistas com professores universitários, oficinas com a Câmara Técnica da Comissão de Integração Ensino-Serviço e participação em encontro com representantes da Região.Resultados: Foram identificadas três categorias relativas ao papel das universidades no desenvolvimento das ações de educação em saúde, bem como ao papel da Comissão de Integração Ensino-Serviço como espaço favorável à articulação dessas instituições. Considerações finais: As universidades assumem papel fundamental no desenvolvimento de ações de educação permanente em saúde, considerando a realidade do território e dos serviços, bem como demandas e potenciais dos atores envolvidos, o que favorece a articulação ensino-serviço na Região.Palavras-chave: Educação continuada. Pesquisa em enfermagem. Serviços de integração docente-assistencial. Educação superior

Immediate expression of c-fos and c-jun mRNA in a model of intestinal autotransplantation and ischemia-reperfusion in situ

OBJECTIVE: Intestinal ischemia-reperfusion injury occurs in several clinical conditions and after intestinal transplantation. The aim of the present study was to investigate the phenomena of apoptosis and cell proliferation in a previously described intestinal ischemia-reperfusion injury autograft model using immunohistochemical markers. The molecular mechanisms involved in ischemia-reperfusion injury repair were also investigated by measuring the expression of the early activation genes c-fos and c-jun, which induce apoptosis and cell proliferation. MATERIALS AND METHODS: Thirty adult male Wistar rats were subjected to surgery for a previously described ischemia-reperfusion model that preserved the small intestine, the cecum and the ascending colon. Following reperfusion, the cecum was harvested at different time points as a representative segment of the intestine. The rats were allocated to the following four subgroups according to the reperfusion time: subgroup 1: 5 min; subgroup 2: 15 min; subgroup 3: 30 min; and subgroup 4: 60 min. A control group of cecum samples was also collected. The expression of c-fos, c-jun and immunohistochemical markers of cell proliferation and apoptosis (Ki67 and TUNEL, respectively) was studied. RESULTS: The expression of both c-fos and c-jun in the cecum was increased beginning at 5 min after ischemia-reperfusion compared with the control. The expression of c-fos began to increase at 5 min, peaked at 30 min, and exhibited a declining tendency at 60 min after reperfusion. A progressive increase in c-jun expression was observed. Immunohistochemical analyses confirmed these observations. CONCLUSION: The early activation of the c-fos and c-jun genes occurred after intestinal ischemia-reperfusion injury, and these genes can act together to trigger cell proliferation and apoptosis

Representações sociais de adultos soropositivos sobre vírus da Imunodeficiência Humana e Aids

Objective: to identify the social representations of the Human Immunodeficiency Virus (HIV) and the Acquired Immunodeficiency Syndrome (AIDS) among HIV-positive adults. Method: exploratory-descriptive field research, with a qualitative approach, based on the Theory of Social Representations, carried out from 2017 to 2018, in the city of Recife, Pernambuco, Brazil, applied 129 questionnaires of free evocations with adults living with HIV and 30 semi-structured interviews. Prototypical and lexical analysis was used. Results: Results: we observed representational contents linked to the beginning of the epidemic, such as prejudice and death, reflecting on their historical basis, as well as contents related to a perspective of normality of the disease. Conclusion: it was demonstrated the existence of a process of change in the representations, initially linked to death, but later, a view of normality, probably as a consequence of living with the disease, through the new context that allows greater survival.Objetivo: identificar las representaciones sociales de adultos VIH positivos sobre el Virus de Inmunodeficiencia Humana (VIH) y el Síndrome de Inmunodeficiencia Adquirida (SIDA). Método: investigación de campo exploratoria-descriptiva, con enfoque cualitativo, basada en la Teoría de las Representaciones Sociales, realizada de 2017 a 2018, en la ciudad de Recife, Pernambuco, Brasil; se aplicaron 129 cuestionarios de evocaciones libres con adultos que viven con VIH además de 30 entrevistas semiestructuradas. Se utilizó análisis prototípico y de léxico. Resultados: se observaron contenidos representacionales vinculados al inicio de la epidemia, como el prejuicio y la muerte, reflexionando sobre su base histórica, así como contenidos relacionados con una perspectiva de normalidad de la enfermedad. Conclusión: se demostró la existencia de un proceso de cambio en las representaciones, inicialmente ligado a la muerte, pero luego, una visión de normalidad, probablemente como consecuencia de vivir con la enfermedad, a través del nuevo contexto que permite una mayor supervivencia.Objetivo: identificar as representações sociais de adultos soropositivos acerca do Vírus da Imunodeficiência Humana (HIV) e da Aids. Método: pesquisa de campo, do tipo exploratório-descritiva, com abordagem qualitativa, fundamentada na Teoria das Representações Sociais, realizada de 2017 a 2018, na cidade do Recife, Pernambuco, Brasil, aplicados 129 questionários de evocações livres com adultos vivendo com HIV e 30 entrevistas semiestruturadas. Utilizou-se da análise prototípica e lexical. Resultados: observaram-se conteúdos representacionais atrelados ao início da epidemia, como preconceito e morte, refletindo sobre a base histórica destes, como conteúdos relacionados a uma perspectiva de normalidade da doença. Conclusão: demonstrou-se existência de processo de mudança nas representações, inicialmente ligadas à morte, porém, posteriormente, visão de normalidade, provavelmente como consequência da convivência com a doença, por meio do novo contexto que possibilita maior sobrevida

Analysis of the reversibility of biliary cirrhosis in young rats submitted to biliary obstruction followed by desobstruction

In this letter to the editor of Revista de Medicina, we present a summary of our study entitled “Analysis of the reversibility of biliary cirrhosis in young rats submitted to biliary obstruction followed by desobstruction”, presented at the XXXV COMU in 2016 - 1st place of Oswaldo Cruz award, surgical area.Biliary atresia and other liver conditions are relevant in pediatric clinic, due to its progression into biliary cirrhosis and eventually, necessity for liver transplant. It is known that the period during which biliary obstruction persists is determining for the development of cirrhosis and its reversibility after a biliary drainage procedure. However, there are no time or histological markers of biliary cirrhosis reversibility. An animal model of biliary obstruction and desobstruction was employed and after histologic and molecular analysis, we concluded that, considering the high mortality rate and the improvement in histologic and molecular changes after biliary drainage in most groups, cirrhosis and its histological and molecular changes occur early after biliary obstruction, are severe and potentially fatal, but can be reversed or at least delayed after biliary drainage

Migração celular distinta induzida por Leishmania infantum chagasi e saliva de Lutzomyia longipalpis em um modelo de pool hemorrágico

Recruitment of a specific cell population after Leishmania infection can influence the outcome of the disease. Cellular migration in response to Leishmania or vector saliva has been reported in air pouch model, however, cellular migration induced by Leishmania associated with host's blood and vector saliva in this model has not been described. Herein we investigated cellular migration into air pouch of hamster after stimulation with combination of L. chagasi and host's blood and Lutzomyia longipalpis saliva. Migration induced by saliva was 3-fold more than those induced by L. chagasi alone. Additionally, L. chagasi associated with blood and saliva induced significantly even more leukocytes into air pouch than Leishmania alone. L. chagasi recruited a diverse cell population; however, most of these cells seem to have not migrated to the inflammatory exudate, remaining in the pouch lining tissue. These results indicate that L. chagasi can reduce leukocyte accumulation to the initial site of infection, and when associated with vector saliva in the presence of blood components, increase the influx of more neutrophils than macrophages, suggesting that the parasite has developed a strategy to minimize the initial inflammatory response, allowing an unlimited progression within the host. This work reinforces the importance of studies on the salivary components of sand fly vectors of leishmaniasis in the transmission process and the establishment of the infection.O recrutamento de uma população de células específicas após infecção por Leishmania pode influenciar o resultado da doença. A migração celular em resposta a Leishmania ou saliva do vetor tem sido reportada utilizando o modelo da bolsa de ar subcutânea, entretanto, a migração celular induzida por Leishmania associada com o sangue do hospedeiro e saliva do vetor neste modelo ainda não foi descrita. Neste trabalho foi investigada a migração celular no modelo da bolsa de ar subcutânea em hamster após a estimulação com a combinação de L. chagasi, sangue do hospedeiro e saliva de Lutzomyia longipalpis. A migração induzida por saliva foi três vezes maior do que a induzida por L. chagasi sozinha. Adicionalmente, L. chagasi associada com sangue e saliva induziu significativamente ainda mais leucócitos no exsudato inflamatório do que o estímulo com Leishmania sozinha. L. chagasi recrutou uma população de células distintas, no entanto, a maioria dessas células parece não ter migrado para o exsudato inflamatório, permanecendo no tecido da bolsa de ar. Estes resultados indicam que L. chagasi pode reduzir o acúmulo de leucócitos para o local inicial da infecção e que quando associada à saliva do vetor e na presença de componentes do sangue aumenta o influxo de mais neutrófilos do que macrófagos, sugerindo que o parasito desenvolveu uma estratégia para minimizar a resposta inflamatória inicial, permitindo uma progressão ilimitada dentro do hospedeiro. Este trabalho reforça a importância de mais estudos sobre os componentes da saliva dos vetores das leishmanioses no processo de transmissão e no estabelecimento da infecção